Provider Demographics
NPI:1609899780
Name:ALLEN AUDIOLOGY & WESTGATE HEARING, INC.
Entity Type:Organization
Organization Name:ALLEN AUDIOLOGY & WESTGATE HEARING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:H.
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:WIDDOWSON
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:610-439-1196
Mailing Address - Street 1:401 N 17TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5034
Mailing Address - Country:US
Mailing Address - Phone:610-439-1196
Mailing Address - Fax:610-434-2200
Practice Address - Street 1:401 N 17TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5034
Practice Address - Country:US
Practice Address - Phone:610-439-1196
Practice Address - Fax:610-434-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000096L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAWI205998Medicare PIN